Provider Demographics
NPI:1316403975
Name:MOUNTAIN VIEW MASSAGE & BODYWORK
Entity Type:Organization
Organization Name:MOUNTAIN VIEW MASSAGE & BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-531-3526
Mailing Address - Street 1:9215 219TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-9290
Mailing Address - Country:US
Mailing Address - Phone:406-531-3526
Mailing Address - Fax:
Practice Address - Street 1:400 E PIONEER STE 202
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3257
Practice Address - Country:US
Practice Address - Phone:406-531-3526
Practice Address - Fax:253-375-6688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty